Brother (59) with diffuse large B-cell NHL stage 4 (started in neck) taking Prednizone (10 days into 30-day supply ) but refusing chemo/stopped seeing doctor. Feels better so far. What happens when steroids run out?

The prednisone alone isn't doing much. I mean it is believed to have some anti-cancer activity but it is part of the R-CHOP regimen for several reasons. I think the same thing happening to him now isthe same thing that will happen to him when the Pred has run out-- his cancer will most likely continue to spread, and that eventually he won't feel so well, and eventually, most likely, the inevitable. The prednisone might have him feeling better but that's one of its side effects.

19 days ago, docs at leading cancer ctr said he had 45%-plus chance of "cure" with R-CHOP chemo, and were blunt about it being fatal if he delays. Prior to cancer he was reasonably healthy. Any experience with people refusing chemo when they have a chance at cure? He won't see psychiatrist.

Not really. Choosing hospice over chemo etc makes more sense to the rest of us when the diagnosis is say stage IV lung cancer and the treatment options are few. DLBCL does generally respond really well to front-line therapy. Has he undergone any chemo yet? If he became especially sick afterwards, his docs could likely mitigate some of that prior to his next infusion with prophylactics. Is he just depressed?

He has never had chemo, and is not depressed. Chemo side effects are not scaring him off. His avoiding medical treatment until things get desperate reflects deep,long term pattern. I wondered if this has been systematically studied by psychiatrists or has a name.

Another question - he just quit 60 mg/day Prednisone, after taking it for 20 days, without tapering off. Is stopping from that dose level likely to create immediate life-threatening consequences? I've seen long list of risks of stopping suddenly, but can't tell which are common vs rare.

Perhaps he should watch last Sunday's interview on 60 Minutes with Steve Jobs' biographer, who said Jobs deeply regretted not pursuing conventional therapy for his treatable cancer until it was too late to treat.

As for the prednisone, I don't think that 20 days is long enough to develop any serious dependence and cause any massive withdrawal symptoms, but I'm not qualified to actually draw that conclusion, it's only based on experience, I would call and ask a pharmacist. Doesn't need to be his pharmacist, any qualified, accredited one will do. I think his docs should be notified as well even though he's not taking any more treatments, simply because they should be notified of any changes to what he's doing.

Thanks for the tip on Steve Jobs cancer story. I also checked with a pharmacist who thought the negative effects from abruptly stopping Prednisone after taking it for 20 days at 60 mg/day, to stop neck swelling, would not be life threatening.

Best of luck, I do hope things work out for yall.